Xchange Point Resumes Fight Against AIDS on the Streets

By Harold Dopman

May Day 1997: It’s a Cleveland kind of May Day with hard falling rain sometimes mixed with sleet and gusting winds intense enough to turn a person into a kite. The corner of East 105 and Morrison moves deliberately this morning.

Ken Vail, Executive Director of Xchange Point, Cleveland’s much maligned “roving harm reduction” needle exchange program happily ignores the weather, opens the trunk of his car and removes a special black box used for disposing of bio-hazardous materials. In this case, “points” or dirty needles and syringes that could have been used by a HIV infected junkie.

“Always make sure the bag sits up like this,” Vail instructs Chris, a college educated recovering heroin addict who has been clean for 137 days. A formally homeless white man in his late 30’s Chris adds credibility to the program from the junkie’s point of view.

Ken Vail had just proven that you CAN beat City Hall. If you have a good program, an indomitable spirit and are willing to work day and night for months, you can overcome official lack of vision and ignorance.

The City of Cleveland, reversing its position, was in the process of issuing a joint press release with Xchange Point, announcing an agreement of terms for the resumption of needle exchange. Armed with a copy of the first draft of the agreement he quickly serviced his first client, copying the client’s ID number from his Xchange Point ID onto a daily log sheet and adding—2 points in—2 points out.

“Now, Ken, as long as I got this card on me—the police can’t do nothing. Right?” asked the client.

“They shouldn’t as long as you’re clean “assured Vail.

“If they do, we’ll stand behind you. But, if you’ve got dope on you…”

“I know,” the man finished the sentence, “I’m on my own.”

The mayor’s press release states: “Currently in the Greater Cleveland area there are 1,015 individuals diagnosed with AIDS and an estimated five to eight thousand living with HIV. Since the start of the epidemic 2,274 individuals have been diagnosed with AIDS in Greater Cleveland.

In response, the City of Cleveland issued an emergency order two years ago to allow a needle exchange program to operate a stationary program at the Free Clinic. A “stationary” program allows user to exchange used needles for clean ones at a specific site.

Vail, who was director of the program wanted to expand it to include a “roving” program, which would travel to various locations in neighborhoods; but ran into conflict with the Free Clinic and was asked to resign. He refused and was fired.

“The problem is that when a heroin addict needs dope and doesn’t have a clean needle he’ll use a dirty one. Whether or not he can contract AIDS really isn’t an issue,” said Chris explaining the need for additional programs.

“In other cities,” Vail added, “up to ten different needle exchange programs exist.”

Vail formed a non-profit agency, Xchange Point, and started a “harm reduction” program.

“Practicing harm reduction is more than just exchanging needles to prevent the spread of AIDS,” explained Dr. Joy Marshall, medical director of Xchange Point and former director of the Free Clinic.

“We talk to the people about safe sex and other health problems. We tell them about drug treatment programs that are available.”

When Xchange Point complied with city regulations, the City revised the rules. Police surveillance and threats of prosecution followed and Vail was forces to cease exchanging needles.

Vail took his case to the media—anyone who would listen. He faxed press releases and made phone calls. Articles soon appeared in The Free Times, The Homeless Grapevine and other publications.

Originally, The Plain Dealer was against needle exchanges, but eventually reversed its position and ran a feature article about Vail and Xchange Point along with a cover photo of Vail in The Sunday Magazine.

“No one event changed my mind about the program,” said Phillip Morris, Plain Dealer editorial writer. “It was a gradual realization that needle exchange programs, including Xchange Points program were good and would help to slow the spread of HIV.”

At the end of the hour Vail took inventory of the days activities. Three people had exchanged four needles, one had requested a needle cleaning kit and one person came by for free condoms.

“It’s a start”, said Vail, wiping rain from his still happy face. “Nobody knew we were coming today. By the time we come back, the work will be out on the street and a lot more clients will be here.”

Coming to Cleveland during the summer of 1998 will be The Harm Reduction Coalition’s 2nd National Harm Reduction Conference. Over 1500 participants from all over the country will convene here to discuss the latest advancements in harm reduction philosophy.

Copyright for the Homeless Grapevine and NEOCH, Issue 21, Cleveland Ohio June 1996